RESUMEN
In 15 women with either isolated amenorrhea or amenorrhea associated to galactorrhea the basal levels of PRL allowed a clear differentiation into three groups. The first group (n = 3) had normal PRL levels (x +/- SD, 8.0 +/- 4.8 ng/ml), the second group (n = 4) had moderately elevated PRL (25.6 +/- 6.5 ng/ml), and the third group (n = 8) had very high PRL (176.0 +/- 76.1 ng/ml). All the patients in the third group had a pituitary adenoma. In the three groups the basal levels of FSH and LH and their response to GnRH were measured with the purpose of uncovering possible relationships between these results and the levels of PRL, and the tumoral or non-tumoral origin of the hyperprolactinemia when it was present. No statistically significant differences were found amongst the three groups. The results suggest that hyperprolactinemia has no influence upon gonadotrophin release or the endogenous release of GnRH. The measurement of plasma gonadotrophins and their response to GnRH appears to be of no clinical value for the differential diagnosis of the hyperprolactinemias.
Asunto(s)
Amenorrea/sangre , Galactorrea/sangre , Trastornos de la Lactancia/sangre , Hormonas Adenohipofisarias/sangre , Adenoma/sangre , Adulto , Amenorrea/complicaciones , Diagnóstico Diferencial , Femenino , Hormona Folículo Estimulante/sangre , Galactorrea/complicaciones , Humanos , Hormona Luteinizante/sangre , Hormonas Liberadoras de Hormona Hipofisaria/farmacología , Neoplasias Hipofisarias/sangre , Embarazo , Prolactina/sangreRESUMEN
Basal and stimulatory tests of FSH, LH and PRL are reported in three cases of hypogonadism-anosmia syndrome (Maestre-Kallmann-De Morsier syndrome), two of whom were brothers. Basal FSH levels were low (mean = 1.7 mU/ml) and did not respond to the first acute stimulation with intravenous LRH (x = 2.3 mU/ml), but after intramuscular LRH, 500 microgram/day for 10 days, a clear-cut response was noted in two patients (from a mean of 7.8 mU/ml to 16.8 mU/ml), while the other patient continued without response. Low basal LH levels (mean 1.8 mU/ml) responded poorly to the first LRH stimulation (mean 4.6 mU/ml), while after intramuscular LRH for 10 days there was a marked increase in all three cases (mean 29.7 mU/ml). In no case was there a response to clomiphene. With regard to PRL, all cases had a clear response to TRH, although it was subnormal in two of them. Opposite results were obtained in one case of Klinefelter's syndrome, namely, elevated basal PRL levels (44 ng/ml) with an exaggerated response to TRH. Chlorpromazine administration caused an elevation of PRL to 43 and 30 ng/ml, respectively, in the two patients with a subnormal response to TRH, while the third case responded less than to TRH. In conclusion, the response to TRH of FSH and LH with lack of response to clomiphene supports the hypothalamic nature of the hypogonadism, while the response of PRL to both TRH and chlorpromazine, along with the normal levels of the remaining pituitary hormones (ACTH, TSH and STH) demonstrate the selectivity of the hypothalamic lesion whereby only gonadotrophin control is impaired.
Asunto(s)
Clorpromazina/uso terapéutico , Hipogonadismo/tratamiento farmacológico , Trastornos del Olfato/tratamiento farmacológico , Prolactina/metabolismo , Hormona Liberadora de Tirotropina/uso terapéutico , Adolescente , Adulto , Femenino , Hormona Folículo Estimulante/metabolismo , Humanos , Hipogonadismo/genética , Hipogonadismo/metabolismo , Hormona Luteinizante/metabolismo , Masculino , Trastornos del Olfato/genética , Trastornos del Olfato/metabolismo , Estimulación Química , SíndromeRESUMEN
A girl with Bloom's syndrome is reported. We have not found chromosomic or inmunoglobulin alterations, in opposition to described by other. We remark, for the first time in medical literature, a deficit of GH secretion without response to several stimulus. The other hormonal explorations were normal. We don't know if, that finding will be of pathogenic importance for the stunted growth of Bloom's syndrome or this is a casual association. Anyway, the good therapeutic results with the exogenous human growth hormone administration, is of a great interest for the investigation of pituitary GH reserve in any case of Bloom's syndrome.
Asunto(s)
Dermatosis Facial/etiología , Hormona del Crecimiento/deficiencia , Telangiectasia/congénito , Niño , Enanismo/complicaciones , Dermatosis Facial/tratamiento farmacológico , Femenino , Hormona del Crecimiento/administración & dosificación , Humanos , Síndrome , Telangiectasia/complicacionesAsunto(s)
Clomifeno/farmacología , Defectos de la Visión Cromática/tratamiento farmacológico , Eunuquismo/tratamiento farmacológico , Gonadotropinas/metabolismo , Hipogonadismo/tratamiento farmacológico , Discapacidad Intelectual/tratamiento farmacológico , Hormonas Liberadoras de Hormona Hipofisaria/uso terapéutico , Hormona Folículo Estimulante/metabolismo , Humanos , Sistema Hipotálamo-Hipofisario/efectos de los fármacos , Inyecciones Intravenosas , Hormona Luteinizante/metabolismo , Masculino , Tasa de Secreción/efectos de los fármacos , Estimulación Química , Síndrome , Testosterona/metabolismoAsunto(s)
Errores Innatos del Metabolismo de los Carbohidratos/diagnóstico , Hipogonadismo/diagnóstico , Obesidad/diagnóstico , Adulto , Hormona Folículo Estimulante/análisis , Humanos , Sistema Hipotálamo-Hipofisario/fisiopatología , Discapacidad Intelectual/diagnóstico , Hormona Luteinizante/análisis , Masculino , SíndromeRESUMEN
The authors reviewed 83.250 clinical histories from the files of a hospital, among which they found 49 thyroid carcinomas whose characteristics they study. It is interesting to note the great incidence of papilliferous carcinoma (53 per cent of cases); a most marked incidence of the condition in female patients; the slight difference in the age of the patients with all types of carcinoma; and, above all, the atypicity of the onset symptoms in a large number of cases (28 per cent). According to these data, the authors suggest that it is advisable to bare in mind the possibility of the presence of thyroid carcinoma in patients with such unmatched pictures as suppurative thyroiditis, sciatica or cervical adenopathy, with absence of goiter, etc.